Healthcare Provider Details

I. General information

NPI: 1427367788
Provider Name (Legal Business Name): THOMAS H. HOHL, D.D.S., P.S., ORAL & MAXILLOFACIAL SURGERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2010
Last Update Date: 10/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4540 SAND POINT WAY NE STE 360
SEATTLE WA
98105-3941
US

IV. Provider business mailing address

4540 SAND POINT WAY NE STE 360
SEATTLE WA
98105-3941
US

V. Phone/Fax

Practice location:
  • Phone: 206-522-2212
  • Fax:
Mailing address:
  • Phone: 206-522-2212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS0112X
TaxonomyOral and Maxillofacial Surgery Clinic/Center
License NumberDE 00004289
License Number StateWA

VIII. Authorized Official

Name: DR. THOMAS H HOHL
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 206-522-2212